Appointment with GP - heart sunk

[MarriedThreeChildren]

Had an appointment last week with my GP. I’ve had a bad flare up from a chronic illness.

Went through everything, agreed to be referred back to hospital consultant. And then came the killer question

Do you have an insurance and want to go private or are we going NHS?

With the clear feeling that really the ‘right’ answer was going private :(:(

Since when is the NHS pushing patients to go private? Not so long ago it was such a big No-No. No GP would ever ask that question as a routine question. Rather people would ask if they knew they could get quicker/see who they wanted to see.

But here we go. The system is so fucked up that GPS are now trying to push people to go private rather than NHS.

I find it extremely worrying (I mean which insurance will ever cover me with a chronic condition that has been there for 15 years anyway??). Is it now the only way to get some decent medical support?
I have no idea when I will be able to see the consultant. GP ‘wasn’t aware about the lead times’ (last time I went to see them the wait was about 1 years. It was pre covid etc…. So I suspect…. much more than that…)

people live longer and continue to be treated, children who would not have been born or who would have died young, survive.

This is a large part of it. Universal very basic healthcare eg vaccinations is cost-neutral or even positive, as you are converting deaths into healthy future taxpayers. And when the model was about fixing up otherwise healthy people, it still worked.
The 'problem' is now that people who would have died live longish lives often dependent on expensive treatment (and in states of health that mean they can't work, even if of working age). Obviously that we are now having this 'dilemma' is a sign of advancement and that we do fundamentally value life, but it does mean some difficult conversations.
The tide is turning a little, in that many people who see elderly relatives brought through health crises to have lives extended miserably, are increasingly vocal that that's not what they want for themselves. Of course part of this is one's own sense of how one wants to live or not--but the (perceived) waste of NHS funds also gets mentioned.

@jusdepamplemousse

To be fair ten or so years ago I was being advised to go private by the NHS. It’s really disheartening though yes. Hope you get the help you need.

Me too. A few of the receptionists advised it, they could see the way it was going back then.

@Picklypickles

PlainJaneEyre - I've not heard of that one, I usually just buy supermarket own brand hayfever tablets and they've not helped with my ears at all! Is it something I can buy over the counter? If it is I'll have to give it a try!

You can get it from the doc on prescription or you can buy it online with people like these. It's the tablet form of the hay fever injection that people can get.

www.pharmacyonline.co.uk/product-landing/fexofenadine/?ref=PPC&gclid=EAIaIQobChMIk969hp-M9wIVSOrtCh2UxgWZEAQYASABEgKVYfD_BwE

PS My ears are feeling a bit clogged now and it is the start of hay fever season for me. One of these usually relieves the ears for me. Had the blocked ear thing for nearly a year at one point and for 5 months another time. ow I'm not deaf.

@Doggirl

If you go private fine go private. If you need to swap to NHS get back int he queue.

It's more complicated than that IRL, though.

DM went private for what was supposed to be routine surgery. Got blue-lighted to the local NHS hospital due to catastrophic blood loss. She then had the pleasure of hearing one particularly nasty nurse regale anyone passing by about "people who are too la-di-da for the NHS but swan back in here when it goes wrong".

DM basically cashed in her savings to go private. She did it because the NHS hospital wouldn't even give her a date when they were likely to know how long she'd have to waitlet alone a date for her actual operation. Because she was by that point waking up struggling to breathethe NHS hospital didn't even seem to think that breathing was quite important, let alone question whether their diagnosis might be wrong.

Oh yeah, the diagnosis. Done on the basis of completely the wrong scan, and followed by the referral being 'forgotten'. The blood loss was because the surgery (when it eventually came) hit a blood vessel in metastatic cancer no-one knew was there. The private hospital obviously don't get a free pass for missing the signs, but the reason DM even had to go there was because everyone involved in her state care had repeatedly missed big flags for ovarian cancer.

I wasn't talking about an emergency, clearly there isn't a queue for blue lights. I was talking about when the queue is in two parts, part one let's say it is 6 months wait to see the Consultant, he says yes you need an operation, if you want it on the NHS you then join the 2nd part of the queue so maybe another 6 months till the surgery. Meanwhile people who are still waiting in the first queue get pushed further back in the 2nd queue because you've overtaken them by paying for the private consultation.

That isn't fair.

I know you keep saying that this hasn't always been a thing OP, but I was asked if I had insurance 25 years ago (exploratory laparotomy)? I was told on the NHS it would be a watch and wait approach but if I had insurance they could do the op. Glad I did because I was told it would likely have ended in emergency open surgery had it been left.

[quote PlainJaneEyre]@ancientgran

If you go private fine go private. If you need to swap to NHS get back int he queue

It's not as simple as that though is it ? There isn't only one queue - there is one for investigations and then one for action. By paying for an investigation you get onto the second queue as it were faster. You are still in a queue if you go back but it's a different one.[/quote]
I think it is as simple as that. If I'm waiting in queue 1 and you overtake me by paying you are then making queue 2 longer for me because you have effectively "pushed in" to the queue. If you want NHS then wait your turn.

[quote PlainJaneEyre]@ancientgran you are not taking away from anyone on the waiting list as he is not seeing you in NHS time. So no she did not leapfrog NHS patients - she used some of her money to see a doctor privately. People make all kinds of individual choices about how they spend their money.[/quote]
See my answer above about the 2nd queue. If you get referred to the 2nd queue faster because you pay to miss queue one you are leapfrogging the people who are waiting in queue one.

@XingMing

No, *@ancientgran*, I paid a consultation fee for immediate treatment to relieve a complex weeping ezcema covering my entire torso after breast cancer and radioththerapy. Then I went back into the NHS on the same schedule as anyone else, accelerated a little by an urgent referral from the breast cancer clinic and oncology surgeons.

Did you get the referral to the NHS service faster because you'd seen the Consultant faster than if you waited to see them on the NHS? If you did you jumped the queue. If you didn't get referred faster because you saw someone privately then you didn't but people do it all the time and it is unfair to people who can't pay to jump the queue.

I had this after my son had been waiting to start his orthodontic treatment at our local NHS dental hospital after the first lockdown (complex case with hypodontia etc , not just straightforward brace, hence referral from normal orthdontist to dental hospital). He'd already been on the waiting list a couple of years because there was a cockup with the referral. Went for his consultation and a couple of other prep appts and then COVID hit.

All patient lists were paused for over a year and then we got a letter to say they were restarting again and I would get a call soon to discuss. They rang me and said he was effectively back to the start of the queue with his treatment "and did we still want to wait because some people are preferring to go private". I asked the woman was this because there would be a huge wait and she hummed and haaahed and said there could be.

We didn't have a choice financially at the time so said we'd just wait. Months and months later we restarted the whole process over again from the start including initial consultation and more impressions and photographs and X rays . Now he is off to uni in September and STILL has a couple of years treatment left! No idea how he'll fit his appointments in as he's hoping for Cambridge and there'll be no leave in term time. It's nearly a 4 hour drive away from our dental hospital. And also suddenly, in the middle of his treatment they've suggested we need to change the treatment plan. They've tried to say it's because of something that's happened to the roots of his teeth but honestly, part of me thinks it's because they just want to switch to the cheaper option now.....they'd never admit that of course.

The orthodonists and students are superb, they really are. But I have no faith or trust that the funding is what it was and I wish so much that we'd just gone private when they first put the idea to us. Even if we just got a loan....

So I think, OP, that if a medical professional is hinting at private, and you can afford it, or have insurance, then just do it. Don't question it. You may well regret it.

The NHS is awful for many people. Money, staff culture, beauracratic overreach, people misusing it. I recently had the luck to use private care for my own cancer 'scare' because NHS wait was 18 months and I was already losing weight and in pain. Stage two cancer found, removed and back on my feet in a month. It is a rare, aggressive cancer and, had I waited even a few more months, I'd have been looking at stage four and death. I will never use the NHS again. We are lucky; I feel so sorry for people who can't because there will be so many avoidable deaths because NHS is treated like an untouchable sacred cow.

@godmum56

I think a part of it (been around the NHS for a looooooong time) is that more can be done and people's expectations have gone up eg there is better tech for managing stuff like diabetes, more joint replacements are done and more joint replacement revisions are done, there is IVF, people live longer and continue to be treated, children who would not have been born or who would have died young, survive. More cancers are treatable. I am not suggesting that any of this is wrong, of course I am not but it IS expensive....but there is also waste, duplication, bad management as well.

This is a far more eloquent version of how I feel. Very well said.

I have almost always been treated privately, right from being a young child and my children have always been seen privately right from being tiny babies. The GP always asks if we want an NHS or private referral. To be fair, private in my experience is streets ahead of NHS anyway for anything non life threatening so it makes sense. Always been the way

I wasn't talking about an emergency, clearly there isn't a queue for blue lights.

The point is that if she hadn't gone private, she would have looking at death anyway. Either from the inability to breathe (that the NHS didn't seem to think was important) caused by the physical bulk of the cancer, or in it metastasising too far while she waited for the NHS to treat.

The most important thing achieved in DM going private was having the true nature of her condition exposed before it killed her. If the argument is that no-one should get such a reprieve because not everyone can, well, it's an argument...

I think The War of Jennifer's Ear was about 30 years ago so it has been an issue for that long.

@Doggirl

I wasn't talking about an emergency, clearly there isn't a queue for blue lights.

The point is that if she hadn't gone private, she would have looking at death anyway. Either from the inability to breathe (that the NHS didn't seem to think was important) caused by the physical bulk of the cancer, or in it metastasising too far while she waited for the NHS to treat.

The most important thing achieved in DM going private was having the true nature of her condition exposed before it killed her. If the argument is that no-one should get such a reprieve because not everyone can, well, it's an argument...

Obviously for her it was worth it but are you saying that people getting NHS treatment faster because they can pay for an initial appointment is morally right?

@BoodleBug51 I wouldn’t say it’s for nothing. He may still be waiting for investigations if you hadn’t gone private.

@Housetreecar same here! We’ve always had excellent service

I’m about to have a private hip replacement because the local waiting list is years long. Not in an NHS hospital nor using an NHS consultant. After several months, I haven’t even seen a specialist on the NHS - it took 5 months just to get an X-ray. Friend had her hip done around 5 years ago on the NHS, within the 18 weeks that was once the target.

Even without that, my private dental care (no NHS dentists here) and complex specs (very minor NHS contribution) cost me far more per year than my energy bill, or indeed ANY other annual expense. Morally I suppose I could have blown it all on booze and holidays.

I still pay all of my NI, and have had no inpatient care from the NHS since the youngest was born 26 years ago.

I'm not a naysayer, I'm just fed up of paying twice, once through tax, and once again privately to get treatment that in other countries you have to pay once for

But you're not paying tax for your own treatment, you're paying towards the whole of the NHS, including treatment for those who would never be in a position to pay for essential treatment from their own resources. As over 20% of the UK population is living in poverty, that's a lot of people. Would you prefer them to just suffer and/or die?

And if you were to collapse in the street or be injured in an accident, the ambulance that picks you up would be an NHS ambulance, and it would take you to an NHS A&E unit. Both of those services are available to whoever needs them, 24/7. Few, if any, private hospitals have A&E departments.

I'm using insurance through work to get my gallbladder sorted and I've used it for therapy. I'm not sure I'd actually be here if I hadn't had access to the therapy as the waiting list was long and I could never talk about my issues in group therapy.

I'm lucky I have it but wished I didn't need it

I've known a number of people in quite ordinary jobs whose employers provide private health insurance cover. GP's must meet that all the time. I don't see anything wrong with him asking the question ( or any pressure at all to go private).

I once went to the doctor and was told she would refer me to a specialist but it was likely to be eighteen months before I was seen (and this was ~25 years ago). It was only after I got home that it occurred to me that my husband's work gave us health insurance cover, and that this might be an occasion to use it. So perhaps it is good that they check, although I can understand how demoralising it must be if the answer is no.

@PlainJaneEyre

PS My ears are feeling a bit clogged now and it is the start of hay fever season for me. One of these usually relieves the ears for me. Had the blocked ear thing for nearly a year at one point and for 5 months another time. ow I'm not deaf.

I was waiting for an ENT appointment for what my GP thought was probably eustachian tube dysfunction when I got an attack of sinusitis.

A few months later, I bought some OTC, own-brand decongestant tablets from Boots for an attack of sinusitis and my ear problem cleared up while I was taking them.

It may have been coincidence, but as they're only a couple of quid, it's worth a try. And it's never come back, either, I cancelled the appointment.

You should be able to opt out of the NHS, sign something to say you won't claim NHS treatment if you have private healthcare & claim a small reduction on NIC, employees who get private healthcare shouldn't be taxed on the payments as they are saving the NHS money. The NHS model is broken thanks to it being underfunded over the last 20 years.